Speech by Her Royal Highness, Crown Princess Mary of Denmark

24 October 2014, Avicenna Tajik State Medical University

Deputy Prime Minister, Minister of Health and Social Protection, WHO Regional Director, Rector, professors, students, distinguished guests, ladies and gentlemen,
Good morning.

I have been looking very much forward to joining you here this morning at the Avicenna Tajik State Medical University and for the opportunity to say a few words on this occasion as Patron of the WHO Regional Office for Europe.

But firstly I would like to start by thanking the Government of Tajikistan for inviting the Regional Director and myself to visit your beautiful country and for the warm hospitability with which we have been received.

Yesterday, I had the opportunity to visit the Paediatric Hospital and Resource Training Centre and the Chorbogh Child Rehabilitation Centre. It was both an enjoyable and very informative visit, for which I would like to extend my appreciation and thanks to the staff at both centres.

It is the dedication and tireless work of the frontline health workers that assures us that we can attain, as a human right, equitable and universal health for each and every member of each and every community.

Dear students, this morning I had the chance to talk with some of you here on campus. Your ideas and motivation, and your vision of a healthier Tajikistan, are what will form and inspire the future of health care in your country and I applaud you for your commitment to improving the health and well-being of your populations.

The WHO Regional Director for Europe, Ms Zsuzsanna Jakab, and I are visiting Tajikistan to advocate and raise awareness of the importance of maternal and child health issues, as well as immunization efforts.

The issues of preventing maternal mortality, achieving gender equality and ensuring that sexual and reproductive health and rights become a reality for all – no matter who you are or where you live – are close to my heart. Issues that I am dedicated to as a member of the High-Level Task Force for the International Conference on Population and Development, as Patron of the United Nations Population Fund (UNFPA) and the Maternity Foundation, as well as the WHO Regional Office for Europe.

Almost 15 years ago, all Member States of the United Nations made a promise to improve the world through the achievement of eight Millennium Development Goals (MDGs). And much has been achieved: millions of lives have been saved; the number of people living in extreme poverty has halved, and there have been visible improvements in all health areas.

However, the achievement of the MDGs proves to be uneven among and within countries and, alarmingly, the MDGs that are furthest from being achieved are those that have women and girls at their core. Large inequities and inequalities continue to persist and, in some places, are even increasing.

Both the Regional Director and I believe that further progress in improving health and well-being can only be made by reducing inequities – inequities in health systems and gender inequalities. For example, the inequities that people with disabilities face in accessing services, such as health care, rehabilitation, education, employment and social services including, housing and transport.

Here in Tajikistan, reproductive, maternal, newborn, child and adolescent health continue to be priority areas for the collaboration with WHO. To further accelerate efforts in reaching the maternal and child health goals of the MDGs, the Government of Tajikistan in 2011 committed to advancing the United Nations Global Strategy for Women’s and Children’s Health.

With technical and financial support from WHO in 2013, Tajikistan developed and begun implementation of a country roadmap for strengthening accountability of women’s and children’s health. In order to significantly reduce under-5 child mortality, WHO also supported the implementation of the Integrated Management of Childhood Illness (IMCI) strategy with the aim of scaling up coverage and improving quality of services.

It is good to see that the commitment demonstrated by the Government is being put into effective action in addressing health inequalities by: strengthening preventive health services, including immunization and nutrition; improving women’s and children’s access to quality services through integrated approaches; and calling for a stronger intersectoral collaboration to address determinants of health.

Since becoming Patron in 2005, I have expressed my strongest support to universal vaccination through WHO’s immunization initiatives such as, the annual European Immunization Week. Thankfully, immunization coverage in the European Region is high. This is due to the Member States in the Region strengthening their national immunization programmes and the health systems that underpin them.

In 2010, Tajikistan experienced a large polio outbreak; tragically, many people with polio have developed impairments over the last three years and today are in need of long-term rehabilitation care. Yesterday, I had the opportunity to get a better understanding of what it means to live with polio, when I met with polio-affected children and adolescents, their parents and the people that care for them and who are assisting in their rehabilitation.

It is clear that disability is a cross-cutting issue that involves different sectors and diverse actors, and requires strong commitment, resources and actions by many different stakeholders – and of course leadership by the Government.

WHO, in partnership with the Government and the Ministry of Health and Social Protection is in the process of implementing a three-year disability rehabilitation programme. This programme started in June 2013 and comprises the development of a national rehabilitation policy, system and services, with a focus on community based rehabilitation.

By investing in disability and rehabilitation in Tajikistan today, the disability rehabilitation programme is contributing to lay the foundation for a healthy, prosperous and inclusive society for tomorrow, in which people with disabilities can live healthy lives with dignity.

Meeting with polio survivors yesterday and seeing the devastating effects of vaccine-preventable diseases strongly reinforced for all of us the essential nature of maintaining high vaccination coverage. The polio outbreak in Tajikistan and elsewhere in the Region was admirably controlled, as a result of well coordinated efforts and successful vaccination campaigns.

Nevertheless, the outbreak emphasized that there is no room for complacency when it comes to vaccine-preventable diseases. Where immunity gaps are identified they must be addressed.

And today, on World Polio Day, I would like to stress once more that a strong immunization programme is the foundation of any efficient public health system. And access to immunization at every stage of life is the right of every individual.

Using this opportunity, I would like to acknowledge the efforts of the partners in the Global Polio Eradication Initiative, and specifically acknowledge Rotary International for their continuous commitment at the global, regional and local levels. The support provided by the local Rotary Dushanbe District members in response to the polio outbreak in Tajikistan, I understand, was exemplary.

Thankfully, the data on Tajikistan for 2012 indicate that vaccination coverage had increased substantially for all routine vaccinations over the previous seven years among children aged 18–29 months. And that immunization record keeping is improving annually.

These are positive trends and I once again applaud the Government and health professionals for maintaining this progress. I am also particularly pleased to learn that, as the overall economic situation in Tajikistan improves, the Government will continue to broaden the national immunization programme, and consider the introduction of new and underused vaccines in the country.

As Patron of WHO’s Regional Office for Europe, I’m confident that continuing to work together can further improve reproductive, maternal, newborn, child and adolescent health, and reduce the burden of vaccine-preventable diseases in Tajikistan.

Thank you.